Charles Richard O'Bannon in Gresham - Psychologist
Charles Richard O'Bannon - NPI 1508856642
Charles Richard O'Bannon is a Psychologist in Gresham, Oregon. Charles Richard O'Bannon practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Charles Richard O'Bannon is 1508856642. The last update date is 2010-10-25.
Charles Richard O'Bannon's current location address is 123 E Powell Blvd, Gresham, Oregon. You can contact this provider via phone number 5036188041 and fax number 5036188052. The mailing address for Charles Richard O'Bannon is 123 E Powell Blvd, Gresham, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Charles Richard O'Bannon |
|---|---|
| Address | 123 E Powell Blvd, Gresham, Oregon |
| Phone Number | 5036188041 |
| Fax Number | 5036188052 |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1508856642 |
|---|---|
| Provider Enumeration Date | 2005-10-27 |
| Last Updated Date | 2010-10-25 |
Provider Mailing Address Detail
| Address | 123 E Powell Blvd |
|---|---|
| City | Gresham |
| State | Oregon (OR) |
| Post Code | 970307622 |
| Phone Number | 5036188041 |
| Fax Number | 5036188052 |
Provider's Primary Taxonomy Detail
| Speciality | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
| Licence No | 1044 |
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Definition: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and proce |
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What is the unique 10-digit identifier code issued to Charles Richard O'Bannon by the Centers for Medicare & Medicaid Services?
The Charles Richard O'Bannon has been assigned the NPI (National Provider Identifier) 1508856642 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Charles Richard O'Bannon?
The Charles Richard O'Bannon is physically situated at 123 E Powell Blvd, in the city of Gresham, state of OR, with the postal code 970307622.
What is Charles Richard O'Bannon's specialized field of practice, and what is the corresponding taxonomy classification code?
The Charles Richard O'Bannon's area of specialization is Psychologist, and the corresponding taxonomy code that categorizes this field of practice is 103T00000X.
On what date did the Charles Richard O'Bannon receive its 1508856642 assignment from the Centers for Medicare & Medicaid Services?
The Charles Richard O'Bannon was assigned its 1508856642 by the Centers for Medicare & Medicaid Services on 2005-10-27.
As of what date were the details pertaining to Charles Richard O'Bannon last refreshed?
The information related to the Charles Richard O'Bannon, including its address, specialty, and other relevant details, was last updated on 2010-10-25.